Bush Announces Request for $30 Billion, Five-Year Extension of PEPFAR

President Bush on Wednesday called on Congress to double current funding levels for the President's Emergency Plan for AIDS Relief to $30 billion for five years after the program's original mandate expires next year, the New York Timesreports (Gay Stolberg, New York Times, 5/31). PEPFAR directs an authorized $15 billion over five years for HIV/AIDS and tuberculosis primarily to 15 focus countries and provides funding to the Global Fund To Fight AIDS, Tuberculosis and Malaria. PEPFAR's original mandate is scheduled to expire in September 2008, and Bush's request would extend the program for an additional five years. Administration officials have said reauthorization of the program at $30 billion would increase the number of people receiving access to antiretroviral drugs through PEPFAR from 1.4 million to 2.5 million. Bush's announcement comes one week before leaders from the Group of Eight industrialized nations are scheduled to meet in Heiligendamm, Germany, for their 2007 summit (Kaiser Daily HIV/AIDS Report, 5/30).

"Once again, the generosity of the American people is one of the great untold stories of our time," Bush said on Wednesday, adding, "Our citizens are offering comfort to millions who suffer and restoring hope to those who feel forsaken" (New York Times, 5/31). According to Bush, when he first took office, an "HIV diagnosis in Africa's poorest countries was usually a death sentence," adding that PEPFAR funding has "yielded the best possible return: saved lives."

Many international aid organizations, lawmakers and HIV/AIDS advocates applauded Bush's proposal, the Post reports. "With the energy and resources provided by PEPFAR and other programs, there has been impressive progress in the fight against HIV and AIDS worldwide, but the battle is far from won," Sen. Russell Feingold (D-Wis.), who chairs the Committee on Foreign Relation's Africa subcommittee, said, adding, "Right now, only a small percentage of those who need lifesaving drugs are receiving them, while millions more are contracting this preventable virus every year." Natasha Bilimoria -- executive director of the Friends of the Global Fight Against AIDS, Tuberculosis and Malaria -- said that PEPFAR "has made a lifesaving difference to millions of people suffering from HIV/AIDS around the world" (Fletcher, Washington Post, 5/31).

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Meanwhile, some HIV/AIDS advocates said the proposed increase would not keep the pace with increases in new HIV cases during the next five years, the Los Angeles Times reports (Gerstenzang, Los Angeles Times, 5/31). Paul Zeitz, executive director of the Global AIDS Alliance, said it is "important that [Bush] affirmed" PEPFAR, but called the $30 billion request a "modest increase." He said, "By 2013 there will be 12 million people that urgently need" access to antiretrovirals, adding, "We're not getting ahead of the AIDS crisis. We're tempering it" (New York Times, 5/31). Rep. Barbara Lee (D-Calif.) praised Bush for seeking expanded funding but said that PEPFAR needs to go further. According to Lee, the U.S. also should increase spending for malaria and TB, as well as for efforts that could improve the fight against HIV/AIDS but are not a part of PEPFAR -- including education, nutrition, water, food security and health care workers (Los Angeles Times, 5/31).

According to administration officials, the increase in funds will help prevent 12 million new HIV cases and provide care for more than 12 million people. Officials also said the White House is hoping the announcement will encourage other G8 nations, as well as nations that have growing economies, to make pledges. "The goal of universal access isn't a United States goal, it's a global goal," Ambassador Mark Dybul, who serves as the U.S. global AIDS coordinator and administers PEPFAR, said, adding, "The rest of the world is going to need to respond if we are going to achieve these goals" (New York Times, 5/31). Bush on Wednesday also announced that first lady Laura Bush will visit Zambia, Senegal, Mali and Mozambique at the end of June to meet with community leaders and participants in HIV/AIDS programs (Los Angeles Times, 5/31).

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